The present invention relates to a method for reducing the injury to the lower back from biomechanical and overfatigue stress and an improved belt which is particularly useful in the method for reducing the risk of injury to the lower back.
Lower back pain is largely a social and fitness problem. It can be caused by a traumatic injury or can be caused by the general lifestyle of an individual. The kinetic back support belt is a device for accommodating and alleviating this situation. The belt is designed to be used to increase the effectiveness of the abdominal wall in elevating intracavity pressure, in restricting abnormal and stressful trunk motion, in improving skeletal alignment, and in continually training a wearer thereof in proper body mechanics of lifting, stooping, and bending. All of these factors are recommended as contributory factors to a healthy back.
Numerous patents and articles have described devices seeking to achieve one or more of the above aims. However, these devices are not usually useful by a person for the performance of everyday tasks for the protection and reinforced training for persons with or without prior back injury. The kinetic belt can be used by warehouse materials handlers, carpenters, truck mechanics, post-partem mothers, policemen, nurses, meat cutters and homeowners. It may be worn over any clothing at home or at work as a protective device when performing occassional or frequent activities that potentially may sprain the musculo-skeletal structures of the lumbarsacral area. It has been found convenient to use on and off during activities of daily living.
The back support belt is formed of a material having a sufficient rigidity and flexibility and an appropriate size so that when it is properly applied to a user, it creates medically directed forces and pressure points which protect the lower back and prevent injury. The belt is specially designed to contact specific points in the skeletal structure and to increase the intracavity abdominal pressure of the wearer. By increasing this pressure, forces are generated within the abdominal cavity which press against the anterior portion of the lower back and spine. The belt when properly applied, also limits forward, backward and lateral movement of the trunk. In addition to physically limiting or restricting the movement of a wearer, the belt also exerts pressure at specific pressure points when a wearer attempts to bend or move in a direction which could possibly cause back injury. These pressure areas or pressure points act as a form of biofeedback reminding the wearer of allowable and safe limits of trunk flexion and rotation.
In a preferred embodiment, the back support belt comprises an elongate support band having a first and second longitudinal end. The support band is preferably formed of a relatively rigid contiguous material which is rigid enough to maintain its shape during wear and to exert pressure at selected pressure points during wear and at the same time is also flexible enough to be wrapped around a wearer's body and conform to the general contours of the wearer's body. The support band is preferably formed of leather which is 4-8 mm thick, preferably 43/4 to 7 mm thick. However, other materials having similar rigidity and flexibility as leather can also be substituted for leather. The support band is 31/2 to 6 inches wide, preferably 33/4 to 51/2 inches wide, depending upon the height of the individual. The support band is preferably longer than the waist measurement of the wearer, preferably 5 to 11 inches longer than the waist measurement of the wearer and more preferably 6 to 10 inches longer than the waist measurement of the wearer. This overlap length will vary according to pelvic width and the distance between the medical aspects of the anterior superior iliac spines.
The back support belt also comprises means for tightening the belt around a subject. This tightening means is preferably arranged on the belt in a position wherein when the tightening means is connected, the first and second longitudinal ends of the support band overlap the desired distance. The tightening means is also preferably arranged in a manner so that the tightening means applies pressure to both of the overlapped longitudinal ends of the belt to provide for increased intra-abdominal pressure.
The back support belt is preferably formed of an elongate support band formed of a single piece of leather having a substantially uniform width along the entire length thereof. Although it is not absolutely necessary that the belt has a substantially uniform width along the entire length thereof, it is important that the belt, especially in the front and sides thereof, has a width sufficient to apply maximum intraabdominal pressure and prevent forward and lateral bending of the wearer. Another advantage obtained by using a belt having a relatively wide front portion is that when the belt presses against the abdomen, it forces the chest cavity and upper body of the wearer slightly upward thereby relieving inter-disc pressure in the spine.
The tightening means for the back support belt preferably includes a first tightening strap connected with one longitudinal end of the support band and means for adjustably fastening the tightening strap to the elongate support band. The back support belt may also include a second tightening strap connected with the other longitudinal end of the support band which cooperates with said first tightening strap to tighten the support band on the wearer. The first and second tightening straps can be formed of a variety of materials. However, the tightening straps are usually formed of a material which is more flexible than the support band for ease of manipulation. The first and second tightening straps preferably have a width smaller than the width of the support band. If a buckle is utilized to connect the first and second tightening straps, the buckle preferably has a width smaller than the width of said support band whereby the buckle does not discomfort the wearer during forward flexion of the trunk.
In a preferred embodiment the back support belt consists essentially of a 31/2 to 6 inch wide elongate support band having first and second longitudinal ends, said support band being formed of leather which is 4-8 mm thick or being formed of a relatively stiff material having a similar stiffness and flexibility as said leather and tightening means for tightening said belt around the midsection of a subject in a position wherein said first and second longitudinal ends of said support belt overlap between 6 to 10 inches and further wherein said tightening means urges both of said overlapping longitudinal ends of said belt against the abdomen of a subject when being worn.
Because of its unique two-piece design, the kinetic back support belt can be adapted to various work situations by attaching accessories directly to the more rigid wider straps of the support band in the front, back and/or sides thereof without interfering with the more flexible narrow tightening or connecting straps and buckle fastener. Examples of attachments are snaps and loops for tools, safety devices, pockets for carrying, and handle grips on nurses belts for patients to grasp while being lifted from chair to chair.
One of the features that differentiates the preferred embodiment of the belt from other belts is the overlapping front section. Anteriorly, the double thickness in the overlapping front section assists weak abdominal muscles, particularly the rectus abdominis, and provides a posteriorly directed force to increase intraabdominal pressure which has been shown to give longitudinal support to the spine and help control excessive lordosis of the lumbar spine. This is a condition that can arise from overfatigue and back strain. An abdominal pad may be attached to the underflap on the stomach side for even more abdominal pressure. Through pressure points of the sternal half of the tenth rib and the anterior portion of the iliac crest, excessive forward bending is restricted and the user is made aware of safe limits. The upper and lower edges of the sides of the belt are preferably not padded so that the pressure at the pressure points can be felt by the wearer.
Laterally, the edges of the belt band extend distally from the anterior border of the lateral portion of the tenth rib to the iliac crest. This distance varies from 31/2 to 6 inches depending upon the height of the individual. When the belt is tightened, a medically directed force is provided which may slightly limit lateral trunk motions occurring in the thoraco lumbar and lumbar areas. The pressure areas along the inferior border of the tenth rib and the superior border of the iliac crest act as a form of biofeedback reminding the wearer of allowable and safe limits of trunk lateral flexion and rotation. This is perhaps the most hazardous position of spinal mechanics that may lead to a back injury. Preferably, the upper and lower edges of the sides of the belt are not padded so that the pressure at the pressure points can be felt by the wearer.
Posteriorly, the edges of the belt band extend distally from about the thoraco lumbar joint to about the fifth lumbar joint. This provides for anteriorly directed forces which may limit excessive extension of the lumbar spine and thereby decrease lordosis. The pressure areas of the inferior edge of the dorsal portion of the tenth rib and the sacral iliac line of the ilium serve as reminding feedback when excessive extension of the spine is attempted. There is sufficient clearance between the strap and the lumbar spinous processes so as to allow for reduction of lordosis when the intra-abdominal pressure is increased by tightening the belt. This is also especially significant in preventing premature lumbar lordosis when assuming an erect posture from a forward flexed position. Preferably, the back of the belt is not provided with a pad in order to provide sufficient clearance between the support band and the spinous processes. Because of premature lumbar lordosis, the spine is eccentrically loaded and muscular action is needed to maintain it in this off-center balance. This position is inefficient, fatiguing and possibly injurious.
In regards to improving skeletal alignment and continually training the user in proper techniques of body mechanics, the belt of the present invention should be most helpful. Most people wearing a support will voluntarily restrict motion to a great extent because it is either a psychological or a physical reminder. A mildly restricting circumferential device can divert the forces from a particular ligament, relieve any single muscle from bearing the brunt of the force in a particular position, reinforce abdominal muscles and by its very presence and pressures create a set of reflexes of its own which can alter the effect of the underlying reflex reactions. Thus, reeducation and training is achieved by use of the belt of the present invention and the level of awareness to protect the back from injury is raised. This can be achieved if the belt is either tightened for a particular heavy task or loosened in performance of routine activities.
The present invention, in addition to being directed to a novel belt, is also directed to a novel method for limiting the movement of a person and preventing lower back injury. In a broad aspect, the method involves the steps of applying to a person to be treated a back support belt formed of a relatively rigid material and positioning and tightening the belt on the person to increase abdominal pressure and to apply pressure at selected pressure points thereby limiting the trunk motion of the person and reminding the person through biofeedback from assuming positions which would injure the lower back. In a more specific aspect, the method comprises the steps of applying to a person to be treated a back support belt formed of a relatively rigid material; and positioning and tightening the belt on said person to increase the intra-abdominal pressure wherein anteriorly said belt applies pressure to the sternal half of the tenth rib and the anterior portion of the iliac crest to restrict excessive forward bending, laterally the belt extends distally from the inferior border of the lateral portion of the tenth rib to the iliac crest to slightly limit lateral trunk motions occurring in the thoraco lumbar and lumbar areas wherein the pressure from said belt along the inferior border of the tenth rib and the superior border of the iliac crest acts to remind the subject of allowable and safe limits of lateral flexion and rotation, and posteriorly the edges of the belt extend distally from the thoraco lumbar joint to the fifth lumbar joint to limit excessive extension of the lumbar spine and decrease lordosis and wherein pressure areas of the inferior edge of the dorsal portion of the twelfth rib and sacral iliac line of the ilium serve as a reminder to the person when excessive extension of the spine is attempted.